title: High APACHE II score and long length of bowel resection impair the outcomes in patients with necrotic bowel induced hepatic portal venous gas.
abstract: BACKGROUND
  Hepatic portal venous gas (HPVG) is a rare but potentially lethal condition, especially when it results from intestinal ischemia. Since the literatures regarding the prognostic factors of HPVG are still scarce, we aimed to investigate the risk factor of perioperative mortality in this study.
  
  
  METHODS
  We analyzed data for patients with intestinal ischemia induced HPVG by chart review in our hospital between 2000 and 2007. Factors associated with perioperative mortality were specifically analyzed.
  
  
  RESULTS
  There were 22 consecutive patients receiving definite bowel resection. 13 cases (59.1%) died after surgical intervention. When analyzing the mortality in patients after bowel resections, high Acute Physiology And Chronic health Evaluation (APACHE) II score (p<0.01) and longer length of bowel resection (p=0.047) were significantly associated with mortality in univariate analyses. The complication rate was 66.7% in alive patients after definite bowel resection.
  
  
  CONCLUSIONS
  Bowel resection was the only potential life-saving therapy for patients with mesenteric ischemia induced HPVG. High APACHE II score and severity of underlying necrotic bowel determined the results in patients after bowel resection.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Wu
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Tsai
authors.forename: Ming-Tsan
authors.initials: MT
authors.lastname: Lin
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Tien
authors.forename: Tzu-Hsin
authors.initials: TH
authors.lastname: Lin
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D007422:Intestines / Q000098:blood supply / Q000473:pathology* / Q000601:surgery*; D007511:Ischemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000150:complications; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome